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The current study examined the possibility of naturally acquired immunity in Bornean orangutans, <jats:italic>Pongo pygmaeus<\/jats:italic>, exposed to endemic <jats:italic>Plasmodium pitheci<\/jats:italic> malaria. A total of 2140 peripheral blood samples were collected between January 2017 and December 2022 from a cohort of 135 orangutans housed at a natural forested Rescue and Rehabilitation Centre in West Kalimantan, Indonesia. Each individual was observed for an average of 4.3 years during the study period. Blood samples were examined by microscopy and polymerase chain reaction for the presence of plasmodial parasites. Infection rates and parasitaemia levels were measured among age groups and all 20 documented clinical malaria cases were reviewed to estimate the incidence of illness and risk ratios among age groups. A case group of all 17 individuals that had experienced clinical malaria and a control group of 34 individuals having an event of &gt;2000 parasites \u03bcL<jats:sup>\u22121<\/jats:sup> blood but with no outward or clinical sign of illness were studied. Immature orangutans had higher-grade and more frequent parasitaemia events, but mature individuals were more likely to suffer from clinical malaria than juveniles. The case orangutans having patent clinical malaria were 256 times more likely to have had no parasitaemia event in the prior year relative to asymptomatic control orangutans. The findings are consistent with rapidly acquired immunity to <jats:italic>P. pitheci<\/jats:italic> illness among orangutans that wanes without re-exposure to the pathogen.<\/jats:p>","DOI":"10.1017\/s0031182024000155","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T08:00:58Z","timestamp":1708070458000},"page":"380-389","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Naturally acquired immunity to <i>Plasmodium pitheci<\/i> in Bornean orangutans (<i>Pongo pygmaeus<\/i>)"],"prefix":"10.1017","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8813-7344","authenticated-orcid":false,"given":"Karmele Llano","family":"S\u00e1nchez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Kevin","family":"Baird","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aileen","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andini","family":"Nurillah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fitria","family":"Agustina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Komara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fina","family":"Fadilah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendi","family":"Prameswari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raden Taufiq Purna","family":"Nugraha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sugiyono","family":"Saputra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif","family":"Nurkanto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anik Budhi","family":"Dharmayanthi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahadian","family":"Pratama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indra","family":"Exploitasia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex D.","family":"Greenwood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"key":"S0031182024000155_ref31","doi-asserted-by":"crossref","first-page":"548","DOI":"10.4269\/ajtmh.16-0742","article-title":"Case report: severe and complicated cynomolgi malaria in a rhesus macaque resulted in similar histopathological changes as those seen in human malaria","volume":"97","author":"Joyner","year":"2017","journal-title":"American Journal of Tropical Medicine and Hygiene"},{"unstructured":"World Health Organization (2019) World Malaria Report 2019, Geneva, Switzerland, World Health Organization.","key":"S0031182024000155_ref63"},{"key":"S0031182024000155_ref8","first-page":"18","article-title":"Epidemic malaria among transmigrants in Irian Jaya","volume":"23","author":"Baird","year":"2012","journal-title":"Bulletin of Health Research"},{"key":"S0031182024000155_ref21","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5194\/pb-4-47-2017","article-title":"Wild African great apes as natural hosts of malaria parasites: current knowledge and research perspectives","volume":"4","author":"De Nys","year":"2017","journal-title":"Primate Biology"},{"key":"S0031182024000155_ref15","doi-asserted-by":"crossref","first-page":"20182351","DOI":"10.1098\/rspb.2018.2351","article-title":"Predictive analysis across spatial scales links zoonotic malaria to deforestation","volume":"286","author":"Brock","year":"2019","journal-title":"Proceedings of the Royal Society B. 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